As an advanced heart failure and transplant cardiologist, I witness plenty of tragedy. But I don’t lay awake at night anymore grieving bad outcomes — that is the privilege and purview of loved ones. While family and friends may move through Elizabeth Kubler-Ross’ classic stages of grief, doctors do not have that luxury. To give tragedies a purpose, I take three steps when faced with bad outcomes: Separate fault from …
3 steps for doctors who are grieving
My father, recently retired, spent over 40 years in private practice. After dinner, he would sift through piles of paper charts and call patients with their lab results. As a grade schooler, what impressed me the most was that he knew many of his patient’s phone numbers by heart. Of course, this was in the days before HIPAA and caller ID, so scattered charts on the dining table and calling …
The difference between care and service is significant
In the context of human evolution, a vestigial organ is defined as one that has lost all or most of its original function through evolution. Charles Darwin provided a list of vestigial human organs in “The Descent of Man,” including the muscles of the ear, wisdom teeth, the appendix, the coccyx, body hair and the semilunar fold in the corner of the eye. If you had told me 19 years …
Is the stethoscope a vestigial organ?
A few years ago, I missed a diagnosis. I know that’s not earth-shattering, but the stakes are high for a cardiologist. Ms. A was an 82-year-old woman with chest pain. She underwent a transcatheter aortic valve replacement (TAVR) for severe aortic stenosis. The pre-procedure coronary angiogram showed no coronary artery disease and the echocardiogram post TAVR was perfect.
However, a few months after the procedure, she reported arm pain. It was …
The art of diagnosis: How to hear more than what the patient says
I am blessed to love being a doctor. As the child of two physicians, and the fifth generation of physicians in my family, I had no choice but to go to medical school. But from the first day of medical school, I loved it. What a privilege, to know how the human body works! And I didn’t think medical school was particularly fun: I thought it was hard. The first …
10 pieces of advice for new physicians
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